Claudio Tondo, M.D., Ph.D., FESC, FHRS
Heart Rhythm Center, Department of Clinical Electrophysiology and
Cardiac Pacing, Monzino Cardiology Center, Department of Biochemical,
Surgical and Dentist Sciences, University of Milan, Milan, Italy
“ Funding: None”
“ Conflict of interest: None”
Correspondence:
Prof. Claudio Tondo, M.D., Ph.D., FESC, FHRS
Heart Rhythm Center, Department of Clinical Electrophysiology and
Cardiac Pacing,
Monzino Cardiology Center,
Department of Biochemical, Surgical and Dentist Sciences, University of
Milan, Milan, Italy
Via Carlo Parea, 4 – 20128 Milano, Italy
Email address:
claudio.tondo@cardiologicomonzino.it;
claudio.tondo@unimi.it
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In this issue of the Journal of Cardiovascular Electrophysiology, Sayuri
et al discuss the role of isolation of left atrial posterior wall (PWI)
in addition to pulmonary vein isolation (PVI) in the treatment of
persistent AF patients and, in particular with regards to recurrent
atrial arrhythmias (1)
More in detail, the authors compared PVI only strategy to PVI plus PWI
and PWI was achieved through the creation of roof line between the two
superior PVs and bottom line between the two inferior PVs (the so-called
“box lesion”). They found that PWI for persistent AF was more
effective in reducing episodes of recurrent persistent AF with no
increase in recurrent atrial tachycardias (AT). The authors have touched
a very controversial issue and whether the isolation of LPW is required
or promotes additional advantages over PVI alone in patients with
persistent AF is still unclear and debatable argument